Consent and the Six-Year Old

Last night I took my six year old – the stubborn one – to the emergency department at the children’s hospital. She fell off the monkey bars after school and hurt her arm. It seemed likely that it was broken so I took her to the ED to get checked out.

When we arrived and had the initial assessment my daughter was identified as a potential participant in a research study on pain meds. The research nurse came to speak to us and describe the study. Then she left us alone to talk about it and read the information she left behind with us.

I described the study to my daughter and what they wanted her to do if she participated in the study. She was uncomfortable with the idea, although to be honest it was more the idea that they would check her vitals every half hour for two hours after. I think she hoped to be out of hospital and home in less than two hours.

As I write this she is starting her second night in hospital following minor surgery to repair the broken bone in her arm. So her hope to be out in two hours didn’t pan out.

When the nurse came back we asked her a few more questions and then I decided it was up to my daughter to decide what to do. I told her it was her body and she could decide whether to participate. She decided that she didn’t want to do the study.

If it had been up to me I would have said yes because there was potential benefit to her and no significant downsides. However I decided before that point that it was more important for her to have the choice and make the decision herself. There was no value in trying to talk her into something that she didn’t want to do and lots of value in handing over control to her. She is a smart kid who can and wants to be able to make decisions herself.

She asked the questions she wanted to and made the decision herself. I was proud of her. This is her first time in hospital and she was in pain and she made the decision that felt right for her in the circumstances.

I need to remember that and look for more opportunities to hand over the decision-making powers to her so that she can build the confidence that I trust her to make choices for herself and so I can challenge her reasons for making those decisions to help her think through the angles and hopefully learn to make the most informed, conscious decision she can throughout her life.

It will be hard as a know-it-all dad to acknowledge that my little girl is ready to take over some more significant decision-making and hand over those responsibilities to her.